05. Changes in Daily Routines

The information available for review about changes in daily routines for internal medicine residency programs varied widely. All institutions provided communication by email or hand-outs. Some communications were from the leadership (program director, assistant program director, chiefs) and others were from the health system at large. Most documents about policy changes and PPE included links to resources. In general, the documents were detailed and clear about expectations, especially regarding rounding changes and mitigating risk for residents. There were a variety of rounding styles described, including remote rounding and social distancing during rounds. Also, limiting time in patient rooms for trainees by using other modalities like phone calls and telehealth was recommended.

Virtual options for conferences to deliver educational content was adopted by most programs. Guidance on use of telehealth and COVID-19 procedures like Code Blue response were consistently communicated by program leadership. The areas that were not addressed by most institutions were physical exam guidelines, modifications to signout processes, and specific information about pre-rounding changes.